engleski

Study of a long-term effect of topical capsaicin treatment in nasal polyposis

The aim of this study was to estimate efficacy of topical capsaicin treatment in patients with nasal polyposis during a 2-year period. Twelve non-allergic patients with massive sinonasal polyps who were not willing to undergo surgical treatment were included in this study. Six male and 6 female, 7 previously operated, all after ineffective topical steroid treatment. For 3 consecutive days the patients received 0.5 ml 30 mumol/l capsaicin solution sprayed in each nostril, and 100 mumol/l of capsaicin solution on days 4 and 5. The treatment scheme was repeated every 3 months during a 2-year period. The questionnaire was completed right before the first application, a month after the first application, and every 3 months during a 2-year period. Scored symptoms were following: congestion, postnasal drip, nasal secretion, headache, sneezing, cough, facial swelling and olfaction. Symptoms were scored for intensity from 0-3, and for frequency from 0-4. Punch biopsies of the polyps were performed before the application, half an hour after last application and 3 weeks later. Specimens were stained with HE and Giemsa, and immunohistochemically with IgE and IgA monoclonal antibodies. Control specimens were nasal polyps from the operated patients who were not treated with capsaicin. The correlation between some histopathological parameters (IgE, IgA, mastocyte and eosinophil infiltration) and subjective scores was analyzed. Conservative treatment of a massive nasal polyposis with a repeated topical capsaicin application during a 2-year period was estimated. Eight patients had a statistically significant improvement in total symptom scores and in majority of single scores during the observed period. Three patients underwent surgical procedure (FESS) because of a poor improvement after capsaicin therapy. One patient was lost to control. Topical capsaicin treatment was found to be an efficient therapy in the majority of treated patients according to selection criteria in this study, and could be a substitute if other medical or surgical treatment was found inefficient. Because of the small number of patients we are not able to make a conclusion about a possible impact of the observed histopathological parameters on subjective symptom scores.

Nasal polyposis; capsaicin

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